Neurology Flashcards
Patient presents with a 3 week history of severe eye pain, watering and a stuffy nose 3 times a day every day. What is the most likely diagnosis?
Cluster headache
How do you treat cluster headaches?
Sumitriptan
What MUST be ruled out in a patient with a painful 3rd nerve palsy?
Posterior communicating artery aneurysm
A 28 year old lady with epilepsy comes to see the gp as she is hoping to fall pregnant. What supplement advice must she be given?
Folic acid 5mg/day from as soon as you start trying to get pregnant
Epileptic women has been taking phenytoin throughout her pregnancy due to poor seizure control. What must be taken in the last month of pregnancy?
Vitamin K
How would you initially treat status epilepticus in hospital?
4mg IV lorazepam
How is established status epilepticus treated?
IV phenytoin or valproate
Which 2 drugs can be used for migraine prophylaxis?
Topiramate or propanolol
What drug is given in a patient with a sub arachnoid haemorrhage to reduce the chance of complications?
Nimodipine
Which anti emetic can be prescribed in a patient with Parkinson’s?
Domperidone
What is the first line treatment for a teenage boy with JME (Juvenile myoclonic epilepsy)?
Sodium valproate
What is the first line treatment for a teenage girl with JME (Juvenile myoclonic epilepsy)?
Leviteracetam or lamotrigine
What is the first line treatment for focal or partial epilepsy?
Carbamazepine
What kind of seizure often presents with aura, e.g. a change in smell or taste?
Temporal lobe epilepsy (complex partial)
A 24-year-old man with complex partial seizures - what drug is used to treat?
Carbamazepine
First-line anti-epileptic in a 17-year-old girl with tonic-clonic seizures. She is not sexually active but uses the combined oral contraceptive pill to control her periods
Lamotrigine
You review a 24 year old woman in the high dependency unit. She is moaning but unable to form words, and appears to open her eyes when you speak to her. She is unable to follow commands, but withdraws to pain. What is her GCS?
9
M - 4
V - 2
E - 3
What are the features of a third nerve palsy?
- eye is deviated ‘down and out’
- ptosis
- pupil may be dilated
Following recent NICE guidelines, which of the following medications should he be taking upon discharge of an ischaemic stroke, which was treated with aspirin in hospital (i.e. after 14 days)?
Clopidogrel and a statin
A 25-year-old female is found to have a left hemiparesis following a deep vein thrombosis. What is the most likely cause? Explain
Ostium secundum atrial septal defect
The ostium secundum in this patient has allowed passage of an embolus from the right-sided circulation to the left causing a stroke
What is first line therapy for spasticity in patients with MS?
Baclofen or gabapentin
